Provider Demographics
NPI:1518004092
Name:VEENHUIS, PHILIP EDWARD (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:EDWARD
Last Name:VEENHUIS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 TURNERS CROSSROAD S.
Mailing Address - Street 2:#113
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55416-3812
Mailing Address - Country:US
Mailing Address - Phone:763-545-1099
Mailing Address - Fax:
Practice Address - Street 1:250 TURNERS XRD S
Practice Address - Street 2:#113
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55416-1100
Practice Address - Country:US
Practice Address - Phone:763-545-1099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010248892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry